Evaluation of alveolar facial and palatal bone wall thicknesses of teeth in anterior maxillary dentition using cone beam computed tomography (CBCT)

Introduction and Aim: Especially in the aesthetic region, the alveolar bone wall is generally thin and the facial and palatal bone wall thicknesses of the teeth in this region affect the long-term stability of the teeth. The maxillary anterior region is considered a difficult and risky area for implantation or aesthetic surgery operations. The aim of this study was to measure the alveolar facial and palatal bone wall thicknesses of healthy maxillary central incisors, lateral incisors and canine teeth and the distance between the enamel cement junction (CEJ) and the facial bone crest (FBC) with a CBCT device and to determine the relationship between male and female genders and age groups and evaluation of the relationship between the CEJ-FBC distance and the thickness of the facial bone and the anatomical structures before possible surgical interventions such as implantation, socket preservation, aesthetic crown lengthening. Materials and Methods: In this thesis study, 104 CBCT reports obtained randomly from patients aged 20-50 years who applied to our faculty and did not have loss of maxillary central incisor, lateral incisor and canine teeth and were taken for various indications were evaluated retrospectively. Dicom files in the tomography reports of the patients were transferred to the ICAT-vision imaging program, and measurements were made by the same person twice, with an interval of two weeks. Measurements; The distance between the cementoenamel junction (CEJ) and the facial bone crest (FBC) of six teeth in the anterior maxillary dentition, facial bone wall thickness, palatal bone wall thickness and included the relationship between facial bone thickness and the CEJ-FBC length. Measurements were made at a distance of 1 mm, 3 mm, and 5 mm from the alveolar bone crest in the facial and palatal regions, respectively. The relationship of the obtained measurements between genders and age groups was evaluated. Mann Whitney U, Kruskal Wallis-H, Kolmogorov Smirnov Tests and Linear regression analysis were used to analyze the data. Results: It was reported that the length between CEJ and FBC was positively correlated with age, there was no correlation between facial bone thickness and gender, and there was a negative correlation between facial and palatal bone thicknesses and age. It was found that the length between the CEJ-FBC was significantly lower in females than in males, the palatal bone thickness was significantly lower in females only at 3 mm and 5 mm distances from the apex of crest and there was a negative correlation between facial alveolar bone thickness and CEJ-FBC distance in all teeth and only found to be statistically significant in the canine tooth group Conclusion: The minimum 2 mm bone thickness required for optimal aesthetic and functional results in the anterior maxillary region is rarely found in this region. More studies are needed to better understand the effects of age and gender on buccal bone width, palatal bone width, and CEJ-FBC distance. It is recommended to identify risky conditions by radiographic analysis using preoperative CBCT and to choose an appropriate treatment approach.